TY - JOUR
KW - abuse
KW - abuse-deterrent formulations
KW - Addiction
KW - Adolescent
KW - Adult
KW - Analgesics, Opioid/administration & dosage
KW - Cohort Studies
KW - Delayed-Action Preparations
KW - Female
KW - Humans
KW - Male
KW - Medicaid
KW - Medicaid/statistics & numerical data
KW - Middle Aged
KW - misuse
KW - morphine
KW - Morphine/administration & dosage
KW - Naltrexone/administration & dosage
KW - Narcotic Antagonists/administration & dosage
KW - Opioid-Related Disorders/epidemiology
KW - Opioids
KW - opioids with abuse-deterrent properties
KW - Overdose
KW - Patient Acceptance of Health Care/statistics & numerical data
KW - Prescription Drug Misuse/statistics & numerical data
KW - Retrospective Studies
KW - United States
KW - Young Adult
AU - T. J. Cicero
AU - M. Mendoza
AU - M. Cattaneo
AU - R. C. Dart
AU - J. Mardekian
AU - M. Polson
AU - C. L. Roland
AU - S. H. Schnoll
AU - L. R. Webster
AU - P. W. Park
A1 - 
AB - OBJECTIVE: Opioids with abuse-deterrent properties may reduce widespread abuse, misuse, and diversion of these products. This study aimed to quantify misuse, abuse, dependence, and health resource use of extended-release morphine sulfate with sequestered naltrexone hydrochloride (ER-MSN; EMBEDA(R)), compared with non-abuse-deterrent extended-release morphine (ERM) products in Medicaid non-cancer patients. METHODS: Administrative medical and pharmacy claims data were analyzed for 10 Medicaid states from 1 January 2015, to 30 June 2016. Patients were included if they received a prescription for ER-MSN or any oral, non-abuse-deterrent ERM. Index date was the date of first prescription for an ER-MSN or ERM. Abuse/dependence, non-fatal overdose, emergency department (ED) visits, and ED/inpatient readmissions were determined for each participant. An overall measure of misuse and abuse was also calculated. To account for differences in follow-up, all counts are expressed per 100 patient-years. RESULTS: There were 4,857 patients who received ER-MSN and 10,357 who received an ERM. The average age in the two cohorts was approximately 45 years old. From pre-index to follow-up, the number of patients per 100 patient-years with a diagnosis code indicating abuse or dependence increased by 0.91 (95% confidence interval [CI]: 0.85, 0.97) in the ER-MSN cohort and 2.23 (95% CI: 2.14, 2.32) in the ERM cohort. The number of patients per 100 patient-years with an opioid-related non-fatal overdose increased by 0.05 (95% CI: 0.04, 0.06) in the ER-MSN cohort compared with 0.11 (95% CI: 0.09, 0.13) in the ERM cohort. The opioid abuse overall composite score increased by 1.36 (95% CI: 1.24, 1.48) in the post-index period in the ER-MSN cohort compared to 3.21 (95% CI: 3.10, 3.32) in the ERM cohort. CONCLUSION: Misuse, abuse, and dependence events were numerically lower in patients receiving ER-MSN compared with those receiving ERM products.
BT - Postgraduate medicine
C5 - Opioids & Substance Use
CP - 3
CY - England
DO - 10.1080/00325481.2019.1585688
IS - 3
JF - Postgraduate medicine
N2 - OBJECTIVE: Opioids with abuse-deterrent properties may reduce widespread abuse, misuse, and diversion of these products. This study aimed to quantify misuse, abuse, dependence, and health resource use of extended-release morphine sulfate with sequestered naltrexone hydrochloride (ER-MSN; EMBEDA(R)), compared with non-abuse-deterrent extended-release morphine (ERM) products in Medicaid non-cancer patients. METHODS: Administrative medical and pharmacy claims data were analyzed for 10 Medicaid states from 1 January 2015, to 30 June 2016. Patients were included if they received a prescription for ER-MSN or any oral, non-abuse-deterrent ERM. Index date was the date of first prescription for an ER-MSN or ERM. Abuse/dependence, non-fatal overdose, emergency department (ED) visits, and ED/inpatient readmissions were determined for each participant. An overall measure of misuse and abuse was also calculated. To account for differences in follow-up, all counts are expressed per 100 patient-years. RESULTS: There were 4,857 patients who received ER-MSN and 10,357 who received an ERM. The average age in the two cohorts was approximately 45 years old. From pre-index to follow-up, the number of patients per 100 patient-years with a diagnosis code indicating abuse or dependence increased by 0.91 (95% confidence interval [CI]: 0.85, 0.97) in the ER-MSN cohort and 2.23 (95% CI: 2.14, 2.32) in the ERM cohort. The number of patients per 100 patient-years with an opioid-related non-fatal overdose increased by 0.05 (95% CI: 0.04, 0.06) in the ER-MSN cohort compared with 0.11 (95% CI: 0.09, 0.13) in the ERM cohort. The opioid abuse overall composite score increased by 1.36 (95% CI: 1.24, 1.48) in the post-index period in the ER-MSN cohort compared to 3.21 (95% CI: 3.10, 3.32) in the ERM cohort. CONCLUSION: Misuse, abuse, and dependence events were numerically lower in patients receiving ER-MSN compared with those receiving ERM products.
PP - England
PY - 2019
SN - 1941-9260; 0032-5481
SP - 225
EP - 229
EP - 
T1 - Real-world misuse, abuse, and dependence of abuse-deterrent versus non-abuse-deterrent extended-release morphine in Medicaid non-cancer patients
T2 - Postgraduate medicine
TI - Real-world misuse, abuse, and dependence of abuse-deterrent versus non-abuse-deterrent extended-release morphine in Medicaid non-cancer patients
U1 - Opioids & Substance Use
U2 - 30794760
U3 - 10.1080/00325481.2019.1585688
VL - 131
VO - 1941-9260; 0032-5481
Y1 - 2019
ER -